The Myth of Closure

Therapies for grief and loss have traditionally focused on the work of grieving. The goal was to reach an endpoint, now popularly called closure. There are, however, many people who, through no fault of their own, find a loss so unclear that there can be no end to grief. They have not failed in the work of grieving, but rather have suffered ambiguous loss, a type of loss that is inherently open ended. Instead of closure, the therapeutic goal is to help people find meaning despite the lack of definitive information and finality. Hope lies in increasing a family's tolerance for ambiguity, but first, professionals must increase their own comfort with unanswered questions. In this article, the authors, one a poet, the other a family therapist and theorist, offer a unique blending of theory, reflection, and poetry to experientially deepen the process of self‐reflection about a kind of loss that defies closure.     

Introducing the concept of neurobiological foundation of Rorschach responses using the example of Oral Dependent Language

We introduce the concept of “neurobiological foundation” of Rorschach interpretations as an extension of the concept of behavioral representation as a foundation for interpretation of R‐PAS variables. Here, we propose that if there is a parallelism between the mental, verbal and perceptual behaviors occurring within the microcosm of the Rorschach task and those occurring in the external environment [behavioral foundation], then the same brain regions engaged by the test‐taker when producing of a given code, should be engaged also when reproducing, in the external environment, the same psychological processes underlying that specific Rorschach code [neurobiological foundation]. To investigate this concept, we used archival, fMRI data and tested whether producing Oral Dependency Language (ODL) responses would associate with increased activation in brain regions associated with dependency‐related, psychological processes. Results from a sample of 21 non‐clinical volunteers partially confirmed our hypothesis, providing some support to the neurobiological foundation of the ODL code.     

Eye movement desensitization and reprocessing as a therapeutic intervention for traumatized children and adolescents: a systematic review of the evidence for family therapists

Eye movement desensitization and reprocessing (EMDR) is a relatively new form of psychotherapy for post‐traumatic symptoms of relevance to systemic therapists. The literature available on individual EMDR in traumatized children is reviewed in this article. A sample of eight studies was examined, consisting of three controlled trials, two uncontrolled studies and three case reports or series. The controlled trials compared EMDR with waiting list controls or cognitive behavioural therapy (CBT). The study samples were small and their methodological quality variable. In all the studies, the results suggested a positive effect for EMDR but did not appear superior to CBT. It is therefore possible that systemic interventions may be improved by the integration of EMDR and family therapy with children and adolescents.     

Reflecting team processes in family therapy: a search for research

Tom Andersen's Reflecting Team approach is widely (and creatively) employed in family therapy. Despite continuing enthusiasm for the practice, however, there are few journal articles reporting empirical research and only one (now dated) review of the literature. After defining reflecting team processes through practices that are embedded in particular approaches to knowledge construction and theoretical interpretation, we offer an overview of the empirical research found in our search of the literature. In the second half of this article we ask why there is so little existing research in this area. Various possible explanations are explored and future directions proposed. We conclude that a dialogue around the complex interweaving of practice, theory and research (that is, praxis) would be a helpful overall stance to adopt in relation to future work in this area.     

Attention deficit hyperactivity disorder among inmates in Bergen Prison

The aim of this study was to investigate whether clinical findings are consistent with research indicating a high prevalence of attention deficit hyperactivity disorder (ADHD) among prison inmates. Forty‐three male inmates who were referred for ADHD assessment at the health service in Bergen prison participated. Although most of them reported symptoms in accordance with ADHD both in childhood and adulthood, only 35% of the referred inmates fulfilled the criteria for ADHD when a comprehensive assessment was conducted. The results emphasize the importance of a comprehensive assessment when diagnosing ADHD among prison inmates.     

Syntax for calculation of discounting indices from the monetary choice questionnaire and probability discounting questionnaire

The 27‐item Monetary Choice Questionnaire (MCQ; Kirby, Petry, & Bickel, 1999) and 30‐item Probability Discounting Questionnaire (PDQ; Madden, Petry, & Johnson, 2009) are widely used, validated measures of preferences for immediate versus delayed rewards and guaranteed versus risky rewards, respectively. The MCQ measures delayed discounting by asking individuals to choose between rewards available immediately and larger rewards available after a delay. The PDQ measures probability discounting by asking individuals to choose between guaranteed rewards and a chance at winning larger rewards. Numerous studies have implicated these measures in addiction and other health behaviors. Unlike typical self‐report measures, the MCQ and PDQ generate inferred hyperbolic temporal and probability discounting functions by comparing choice preferences to arrays of functions to which the individual items are preconfigured. This article provides R and SPSS syntax for processing the MCQ and PDQ. Specifically, for the MCQ, the syntax generates k values, consistency of the inferred k, and immediate choice ratios; for the PDQ, the syntax generates h indices, consistency of the inferred h, and risky choice ratios. The syntax is intended to increase the accessibility of these measures, expedite the data processing, and reduce risk for error.     

A psychometric evaluation of the Icelandic version of the WHO‐5

The psychometric properties of the Icelandic version of the World Health Organization five wellbeing index (WHO‐5) were evaluated using two samples, a randomly selected sample (N = 3,896) from the Icelandic National Registry and a convenience sample of primary care patients (N = 126). The factor structure of the scale was tested with confirmatory factor analysis (CFA). The correlation between the WHO‐5 and other measures of depression and anxiety were calculated to assess the scale's convergent and divergent validity. The discriminant validity of the WHO‐5 was explored with a receiver operating analysis compared to the Mini International Neuropsychiatric Interview. The CFA indicated that the factor structure of the WHO‐5 was one‐dimensional and factorial invariant between groups. The internal reliability of the WHO‐5 was adequate and the convergent, divergent and discriminant validity of the WHO‐5 was supported. It is concluded that the psychometric properties of the Icelandic version of the WHO‐5 are satisfactory.     

Odors Can Serve as Landmarks in Human Wayfinding

Scientists have shown that many non‐human animals such as ants, dogs, or rats are very good at using smells to find their way through their environments. But are humans also capable of navigating through their environment based on olfactory cues? There is not much research on this topic, a gap that the present research seeks to bridge. We here provide one of the first empirical studies investigating the possibility of using olfactory cues as landmarks in human wayfinding. Forty subjects participated in a piloting study to determine the olfactory material for the main experiment. Then, 24 subjects completed a wayfinding experiment with 12 odors as orientation cues. Our results are astonishing: Participants were rather good at what we call “odor‐based wayfinding.” This indicates that the ability of humans to use olfactory cues for navigation is often underestimated. We discuss two different cognitive explanations and rule out the idea that our results are just an instance of sequential learning. Rather, we argue that humans can enrich their cognitive map of the environment with olfactory landmarks and may use them for wayfinding.     

Object relations and real life relationships: A cross method assessment

This study examines the relationship between the psychoanalytic concept of object relations and real life behavior of being in an intimate relationship among heterosexual women. In a multi‐method approach we used two different measures; the self‐report Bell Object Relations and Reality Testing Inventory (BORRTI; Bell, Billington & Becker, 1986 ) and the performance based Thematic Apperception Test (TAT) Social Cognition & Object Relations Scale‐ Global Rating Method SCORS‐G (Westen, 1995 ) to measure the object relations of 60 women. The Alienation subscale of the BORRTI and understanding of social causality subscale of the SCORS‐G explained 34.8% of variance of the intimate relationship variable. Thus, women involved in a romantic relationship reported lower rates of alienation on the BORRTI and produced TAT narratives that were more adaptive with regard to understanding of social causality as measured by the SCORS‐G than those not currently in a relationship. Results are discussed with reference to the relationship between object relations and real life measures of healthy individuals and in light of the need for a multi‐method approach of assessment.     

Increasing access to low‐intensity interventions for childhood anxiety: A pilot study of a guided self‐help program for Scandinavian parents

Cognitive Behavior Therapy (CBT) is an effective treatment for child anxiety. However, access to treatment is limited. It has been suggested that low‐intensity formats of parent‐delivered CBT may improve access to treatment. Our aim was to develop and pilot‐test the acceptability and effect of a low‐intensity therapist‐guided parent‐delivered group program for anxious children (age 7–12 years) adjusted to the Scandinavian culture. The program required 1.5 hours of therapist‐time per family. Mothers, fathers and children reported on revised child anxiety and depression scale (RCADS) at referral, pre‐ and post‐treatment. Mothers and fathers also gave a qualitative account of their experiences. Thirty‐one families were enrolled and only one family dropped out. Mean age of the children was 9 years. Intent‐to‐treat analyses revealed significant reductions in anxiety and depressive symptoms from pre‐ to post‐treatment for all informants. Large effect sizes were found for child anxiety symptoms as reported by mothers and fathers, and for child depressive symptoms as reported by mothers. Medium to large effect sizes was found for the self‐reported anxiety symptoms by the children, and for depressive symptoms reported by both children and fathers. More than 93% of the parents would recommend the program. Results suggest that our program may provide a new approach to improve access to treatment for anxious children in Scandinavia; however, further research must be conducted before firm conclusions can be drawn.     

Parental socioeconomic status and child intellectual functioning in a Norwegian sample

Socioeconomic status (SES) in childhood has been linked to cognitive function and future academic and occupational success in studies from several countries. However, previous Nordic studies have shown inconsistent results regarding the strength of this link. We therefore investigated the association between SES and cognitive functioning in a sample of 255 Norwegian children, including 151 typically developing children and 104 children with a psychiatric diagnosis. The third edition of the Wechsler Intelligence Scale for Children (WISC‐III) to assess cognitive function was used. SES was defined from maternal and paternal education and family income of typically developing children and of a subsample of children with a psychiatric diagnosis. Multiple adjusted regression analyses were used to investigate the relation between SES and cognitive functioning. The analyses showed that SES explained a significant part of the variance of the full‐scale WISC‐III score and two WISC‐III indices (Verbal Comprehension and Freedom from Distractibility). Overall, the strength of the relations was weaker than expected from reports from other non‐Nordic countries. Parental education was the only significant individual predictor, suggesting that income was of minor importance as a predictor of cognitive functioning. Further studies should investigate how diverse political and socioeconomic contexts influence the relation between SES and cognitive functioning.     

Exploring the longitudinal relationships between the use of grammar in text messaging and performance on grammatical tasks

Research has demonstrated that use of texting slang (textisms) when text messaging does not appear to impact negatively on children's literacy outcomes and may even benefit children's spelling attainment. However, less attention has been paid to the impact of text messaging on the development of children's and young people's understanding of grammar. This study therefore examined the interrelationships between children's and young adults’ tendency to make grammatical violations when texting and their performance on formal assessments of spoken and written grammatical understanding, orthographic processing and spelling ability over the course of 1 year. Zero‐order correlations showed patterns consistent with previous research on textism use and spelling, and there was no evidence of any negative associations between the development of the children's performance on the grammar tasks and their use of grammatical violations when texting. Adults’ tendency to use ungrammatical word forms (‘does you’) was positively related to performance on the test of written grammar. Grammatical violations were found to be positively associated with growth in spelling for secondary school children. However, not all forms of violation were observed to be consistently used in samples of text messages taken 12 months apart or were characteristic of typical text messages. The need to differentiate between genuine errors and deliberate violation of rules is discussed, as are the educational implications of these findings.     

The Underlying Architecture of the Creative Worlds of Children: Young Persons from the UK and China Unwittingly Generate More Concepts that Violate Ontological Category Structure Than Do Older Adults During an Exemplar‐Generation Task

Is our cognition the underlying architecture of the recurrent and pan‐cultural imaginative ideas of children and adolescents? Recent cross‐cultural studies show that children and adolescents recall proportionally more creative, counterintuitive concepts than older adults. One outstanding concern is that cultural transmission is also constrained by how concepts emerge into culture. Hence, a broad sample of age demographics in UK and China (10–58 years; N = 90) participated in an exemplar‐generation task where participants assembled statements exemplifying conceptual categories of positive and negative emotion, imagery, humor, and inferential potential. Multiple regression analysis considering counterintuitiveness and age revealed young persons generated significantly more imaginative, counterintuitive ideas than older adults, in both UK and China groups. This cross‐cultural support for an underlying cognitive architecture of human creativity builds on Ward's (1994) research on structured imagination.     

Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population‐based sample of adolescents

The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population‐based Swedish adolescent sample. A randomly selected cross‐sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15–16 year‐olds and 1,425 17–18 year‐olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.     

Factor structure and aetiological architecture of the BRIEF: A twin study

Executive function is a broad construct that encompasses various processes involved in goal‐directed behaviour in non‐routine situations (Banich, 2009). The present study uses a sample of 560 5‐ to 16‐year‐old twin pairs (M = 11.14, SD = 2.53): 219 monozygotic twin pairs (114 female; 105 male) and 341 dizygotic twin pairs (136 female, 107 male; 98 opposite sex) to extend prior literature by providing information about the factor structure and the genetic and environmental architecture of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000, Child Neuropsychol., 6, 235; Gioia et al., 2000, Behavior rating inventory of executive function, Lutz, FL: Psychological Assessment Resources), a multifaceted rating scale of everyday executive functions. Phenotypic results revealed a 9‐scale, 3‐factor model best represents the BRIEF structure within the current sample. Results of the genetically sensitive analyses indicated the presence of rater bias/contrast effects for the Initiate, Working Memory, and Task‐Monitor scales. Additive genetic and non‐shared environmental influences were present for the Initiate, Plan/Organize, Organization of Materials, Shift, and Monitor and Self‐Monitor scales. Influences on Emotional Control were solely environmental. Interestingly, the aetiological architecture observed was similar to that of performance‐based measures of executive function. This observed similarity provided additional evidence for the usefulness of the BRIEF as a measure of ‘everyday’ executive function.     

On ‘the fear of death’ as the primary anxiety: How and why Klein differs from Freud

It is well known that Melanie Klein held the view that ‘fear of death’ is the primary source of anxiety and that her position is explicitly opposed to that of Sigmund Freud, who maintained that that fear cannot in any way or form be a source of anxiety. In a previous article on Freud's Inhibitions, Symptoms and Anxiety (Blass, 2013), the author argued that, counter to what is commonly portrayed in the literature, Freud's considerations for rejecting the fear of death as a source of anxiety were based on relational and experiential factors that are usually associated with Kleinian psychoanalysis. In light of this affinity of Freud with Klein a question arises as to the actual source of their differences in this context. The present paper offers an answer to this question. The author first presents some of her earlier findings on what led Freud to reject the fear of death as a source of anxiety and then turns to investigate Klein's considerations for accepting it. This takes us beyond her explicit statements on this matter and sheds new light on the relationship of her views regarding death and anxiety and those of Freud. In turn this deepens the understanding of the relationship of Freud and Klein's conceptualizations of the psyche and its internal object relations, pointing to both surprising common ground and foundational differences.